The structure of Turkey’s health services and health coverage system

Over the last decade, Turkey has made impressive advances in its health service system, including

coverage. Indeed, its health transformation program (HTP) – launched in 2003 – has been widely

praised as “a successful example of a country implementing the values and principles of the WHO

Tallinn Charter […] ensuring that health systems are equitable, responsive and fair” (WHO, 2012, p.

28) and is frequently proposed as a best practice case for many countries to learn from (World Bank,

2015).

Turkey’s Health Transformation Program was launched with the objective of organising resources in

healthcare more efficiently, productive and equitable (Giovanis and Ozdamar, 2017). A number of

crucial reforms increased health insurance coverage, expanded benefits, reduced cost-sharing, and

expanded the infrastructure, health human resources, and health services, shaping its current health

structure and contributing to its success. The 2006 Social Insurance and General Health Insurance Law

outlines social security rules and the regulation of the General Health Insurance scheme

Genel Saglik

Sigortasi

(GHIS) through which health services are financed and which covers the majority of the

population.

The universal health insurance is administered by the Social Security Institution (SSI), which in turn

has been established as a merger of three previous insurance funds, namely SSK, Emekli Sandığı

(GEPF) and BağKur. According to the Government of Turkey, it covers 75.2 million people which

responds to approximately 99 per cent of the total population (an increase of 29 per cent compared to

2002) (ESC, 2017). The GHIS provides reimbursement for in- and outpatient preventative, diagnostic

and curative services. It is free for all citizens earning less than 279 TL

per month and beneficiaries

of the Green Card program - a non-contributory health insurance scheme, which is financed by the

Ministry of Finance. Citizens who earn more, pay premiums depending on their annual income

(Giovanis and Ozdamar, 2017).

Figure 32: Responsibilities and levels in Turkey’s health care system

Around 74 US$ on 31 December 2017.

Policy

•Central Government

Funding

•Central Government, SSI,

Private Insurance, Out-of-

pocket

Service

•MoH and University

Hospitals, Private

Healthcare Institutions

Patients